Chapter 8:
Periodontal Diseases

Affiliations: 1: Department of Periodontics and Dows Institute for Dental Research, College of Dentistry, University of Iowa, Iowa City, IA 52242;
2: Center for Oral Health Research, Division of Periodontics, College of Dentistry, University of Kentucky, Lexington, KY 40536

The periodontal diseases are a diverse group of clinical entities in which induction of an inflammatory process results in destruction of the attachment apparatus, loss of supporting alveolar bone, and, if untreated, tooth loss. Historically, the etiology of periodontal diseases has focused on bacterial plaque, microbial by-products, and the host immune response. Bacteria are the primary etiologic factor of periodontal diseases, however, recent evidence also lists yeast and herpesviruses as putative pathogens. Pathogenic bacteria must be able to (i) colonize the host, (ii) evade host defense mechanisms, and (iii) damage host tissues. Mechanisms for each of these required steps for pathogenesis have been identified for many of the periodontal pathogens. This chapter presents examples of pathogenic processes used by selected periodontal pathogens. The importance and correlation of adaptive/acquired immunity in periodontal diseases are proven by several factors. These studies clearly demonstrate the multifactorial nature of periodontal diseases and the need for further research to better identify individuals at risk and for prescription of earlier and more definitive treatment.

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